Peninsula Pharmacy

LBN: Peninsula Pharmacy Inc.
Peninsula Pharmacy is an health care organization with primary practice located at 1414 W Fair Ave Ste 133 , Marquette MI 49855-5408. The organization recently has only one registered license in Suppliers / Long Term Care Pharmacy, which is considered as the primary health care specialty. Peninsula Pharmacy Inc. can be contacted via phone (906) 225-3902, or through Jenema, Tyler J via phone (906) 225-3902.

Contact Information

Primary practice address
1414 W Fair Ave Ste 133 Marquette MI 49855-5408
Phone: (906) 225-3902
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Jenema, Tyler J PHARMD
Phone: (906) 225-3902

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Long Term Care Pharmacy 3336L0003X

Profile Details

NPI number 1366943995
LBN Legal business name Peninsula Pharmacy Inc.
DBA Doing business as Peninsula Pharmacy
Authorized official Jenema, Tyler J PHARMD
Entity Organization
Organization subpart 1 No
Enumeration date Feb 28th, 2018
Last updated Nov 16th, 2022 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366943995 NPPES
Michigan MEDICAID 3408990

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